Effects on Alcohol Consumption and Alcohol Related Harm of a Community-Based Prevention Intervention With National Support in Sweden

ABSTRACT

Background: In order to strengthen local alcohol prevention work in Sweden the Swedish government has for the past almost 15 years commissioned the Public Health Agency of Sweden to initiate a series of community-based alcohol prevention projects. The latest of these, labeled local development with ambitions (LUMA), included 25 municipalities in Sweden. Objectives: Aim of this study is to examine if LUMA municipalities that received financial support, with requirements, increased local alcohol prevention and if alcohol consumption and harm declined. Methods: Twenty-five Swedish municipalities that received financial support aiming to strengthen local alcohol preventing activities (intervention group) were compared to municipalities that did not receive such support (control group, N = 224), before, during, and after the intervention period. Two composite measures of policy and activity were created and used. The composite activity measure includes seven activity indicators and the composite policy measure includes six policy indicators. Harm measures have been selected based on several recommended indicators for monitoring alcohol, tobacco, and other drugs in Sweden. A fixed effects model was used to analyze data. Results: The results reveal that prevention activities increased and several alcohol-related harm indicators were reduced in intervention municipalities (LUMA) compared with in control municipalities. Conclusions: It seems as if financial support, combined with specific requirements and support from the regional and national level, can stimulate local alcohol prevention activities and have a significant effect on alcohol consumption and alcohol-related harm. Similar evaluations in other countries would be of great value for assessing the generalizability of findings.

KEYWORDS:

• Alcohol
• funding
• harm
• intervention
• municipalities
• policy
• prevention

Acknowledgments

The authors would like to acknowledge project assistants Nelleke Heinemanns and Ulrika Boman, who initially administered a large part of the LUMA-evaluation. Furthermore, Associate Professor Mats Ramstedt at Karolinska Institutet contributed with valuable comments on earlier versions of this article. Finally, we would like to thank the Public Health Agency of Sweden for use of prevention data. This study was funded by the Alcohol Research Council of the Swedish Alcohol Retailing Monopoly, grant number 2012-0016.

Declaration of interest

The authors report no conflicts of interests. The authors alone are responsible for the content and writing of the article.